Sally Robinson, a professor of pediatrics at UTMB Children's Hospital in Galveston, TX, offers advice on diagnosing asthma in children in The Galveston County Daily News:

Asthma is the No. 1 reason that children miss school in the United States and the most common chronic illness that sends kids to the emergency room.

Some children have only mild, occasional asthma flare-ups, or only show signs after exercising, while others have such severe asthma that it affects their activity level and causes changes in the way their lungs function.

Asthma is a chronic inflammatory lung disease that causes airways to tighten. Asthma flare-ups often appear to happen without warning, even after weeks or months without symptoms. All children who suffer from asthma have airways that are overly sensitive to triggers, such as exercise, allergies, viral infections and smoke. When children with asthma are exposed to triggers such as these, their airway linings become inflamed, swollen and filled with mucus, and the muscles that line the airways tighten and shrink, which makes it difficult for air to move through them. A child experiencing an asthma flare-up may cough, wheeze and sweat, and may feel tightness in the chest, increased heart rate and shortness of breath.

It’s not easy to diagnose asthma, because children with asthma have different patterns of symptoms. Some children may cough all night but seem fine during the day, while others seem to get chest colds that don’t go away easily. Doctors normally rule out all other possible causes of a child’s symptoms before diagnosing asthma. The doctor may ask the family for asthma and allergy history, perform a physical exam and order tests, such as chest X-rays, blood tests and allergy skin tests.

Each category of asthma is treated differently, because no single remedy works for every child. There are two categories of asthma medications: quick-relief, or “rescue,” medication, and long-term preventative, or “controller,” medications. Prescription asthma medications treat symptoms and causes, so they control asthma effectively. Over-the-counter medicines, home remedies and herbal medicines should not be substituted for prescription asthma medicines, because they cannot quickly and effectively treat the causes or reverse the flare-ups.

Your doctor will provide a written, step-by-step plan, detailing what to do between flare-ups and how to recognize and manage them when they do occur. Families that take the time to learn more about asthma are often the most successful in controlling it.